The Pain That Wasn't Mine: Somatic Empathy in Massage Therapy

Understanding Sympathy Pain: Reflections from More Than 30 Years of Clinical Practice

Written By Valerie DuPree, LMT, CMLDT, CLT, CFT

The Journey of Healing Through Touch

Several years ago, a client visited me with persistent shoulder pain. During our session, we addressed not only her shoulder but also the surrounding tension in her neck, upper back, and chest. The treatment was effective, and she left feeling significantly better.

However, the next morning, I woke up with pain in my own shoulder.

This was not general soreness from work or fatigue from a long day with clients. It was the same shoulder, the same area, and the same type of discomfort she had described.

If this had happened only once, I might have dismissed it. Unfortunately, it has occurred multiple times throughout my career.

Over my thirty-plus years as a massage therapist, I have experienced this phenomenon countless times. A client arrives with neck pain, and later I notice discomfort in my own neck. A client presents with low back pain, and I find myself feeling an ache in my lower back the next day. Headaches, jaw tension, hip pain, and shoulder restrictions—there have been numerous occasions when I have felt remarkably similar symptoms after treating clients.

The pain is usually temporary. It may last a few hours or a couple of days before fading away. Yet, the pattern has repeated itself often enough that I can no longer chalk it up to coincidence.

Many therapists have experienced something similar, though not everyone discusses it openly.

For years, I referred to it as "sympathy pain." It was the only term I had for this experience. As I continued to learn and grow in my profession, I encountered other descriptions such as somatic empathy, empathic pain responses, and energetic transference. Regardless of the terminology, the experience remains the same: occasionally, I feel something that mirrors what my client is experiencing.

Is It Real?

For me, the answer is simple: Yes. The experience is real.

Whether we fully understand why it happens is another question entirely. I realize that some readers may seek a scientific explanation, while others may have their own spiritual or energetic interpretations. After more than three decades of practice, I find myself somewhere in the middle.

I know what I have experienced. I also understand that not everything we experience can be neatly explained.

As therapists, we spend thousands of hours in direct contact with other human beings. We place our hands on people who are hurting, stressed, recovering from surgery, grieving, overwhelmed, or carrying chronic pain. We listen not only with our ears but also with our hands, eyes, and nervous systems.

Over time, something begins to develop. Sensitivity deepens, and awareness sharpens. Many experienced therapists will tell you that they can often sense where a client is holding tension before the client says a word. Sometimes, we notice changes in breathing patterns, facial expressions, or subtle guarding responses that reveal far more than a verbal intake form ever could.

Perhaps it should not be surprising that some therapists become sensitive enough to occasionally experience echoes of what their clients are feeling.

What Science Might Say

Several scientific theories may help explain this phenomenon, though none completely account for what many bodyworkers report experiencing.

Researchers have studied concepts such as somatic empathy, mirror neurons, and mirror-touch synesthesia. These theories suggest that human beings may have the ability to internally simulate or physically resonate with the experiences of others. In simple terms, our brains and nervous systems may be more interconnected than we once believed.

There is also growing recognition of how deeply humans affect one another emotionally and physiologically. We know that stress can be contagious. Anxiety can spread through a room. People unconsciously mirror facial expressions, body language, and emotional states. Could pain sometimes be part of that equation? Perhaps.

However, if I am being completely honest, science has not yet provided an explanation that fully captures what I have experienced throughout my career.

The Perspective Many Therapists Quietly Share

Among massage therapists, energy workers, nurses, hospice workers, and other healing professionals, there is often another perspective discussed privately.

Many believe that when we work closely with another person, especially through therapeutic touch, we establish a connection that extends beyond muscles and joints. Some practitioners describe this as an energetic connection. Others refer to it as intuition. Some simply call it being highly sensitive.

Whatever language is used, the stories are remarkably similar.

One therapist develops knee pain after working extensively with a client recovering from a knee injury. Another notices sadness or grief arise during a session, only to learn later that the client has recently experienced a significant loss. Others report feeling sensations in areas of the body that correspond directly to a client's primary complaint.

I cannot prove these experiences scientifically.

What I can say is that I have heard too many stories from too many experienced practitioners over the years to dismiss them entirely.

A Lesson I Learned the Hard Way

Earlier in my career, I viewed this sensitivity as a sign that I was helping people. In some ways, perhaps it was.

However, I eventually learned that there is an important difference between being compassionate and absorbing what another person is carrying.

For many years, I did not always recognize where my clients ended and where I began. When you genuinely care about people and spend your days helping those who are hurting, that line can become blurry.

Eventually, I realized something important: I do not have to carry a client's pain to help relieve it.

That lesson changed my practice.

Today, I still experience moments when I seem to take on aspects of a client's discomfort.

The difference now is that I no longer feel responsible for holding onto it. I acknowledge it, become curious about it, and then consciously let it go. I can witness pain without claiming it as my own. I can be compassionate without absorbing. I can remain open without becoming overwhelmed.

What I Believe Today

After more than thirty years in this profession, I have become comfortable with uncertainty. I don't know exactly why this phenomenon occurs.

I don't know whether future research will eventually explain it through neuroscience, energetic medicine, or some combination of both.

What I do know is that many experienced therapists have had similar experiences. I know that I have personally experienced them enough times that they have become impossible for me to ignore. Healing is often more complex and mysterious than our current understanding allows.

The longer I practice, the more respect I develop for the things we cannot yet fully explain. Human beings are incredibly complex. Pain is complex. Healing is complex. The therapeutic relationship itself may be far more powerful than we realize.

Perhaps one day we will have better answers.

Until then, I remain curious.

And when I occasionally wake up with a pain that sounds remarkably similar to what a client described the day before, I no longer rush to explain it away. Instead, I acknowledge the experience and file it alongside the countless other lessons this profession has taught me over the years.

Some things are learned from textbooks.

Others are learned through thirty years of placing your hands on people and paying attention.

Author's Note - This article reflects my personal observations and experiences gathered over more than three decades of clinical practice. While concepts such as somatic empathy, mirror-touch phenomena, and energetic connection continue to be explored by researchers and practitioners alike, many aspects of these experiences remain beyond current scientific understanding. My intention is not to provide definitive answers, but rather to share an experience that many therapists quietly report and that I have personally encountered throughout my career.

References & Further Reading

Engel, Cindy. Another Self: How Your Body Helps You Understand Others.* A pioneering exploration of somatic empathy and the ways human beings may physically perceive and experience the states of others.

Ward, Jamie. Research on mirror-touch synesthesia and embodied empathy. Explores how some individuals experience physical sensations when observing the experiences of others.

Levine, Peter A. Waking the Tiger: Healing Trauma.* A foundational work examining the body's role in storing, processing, and releasing trauma.

van der Kolk, Bessel, M.D. The Body Keeps the Score

American Massage Therapy Association (AMTA). Articles and professional resources discussing empathy, therapeutic presence, practitioner well-being, and compassion fatigue within massage therapy practice.

Massage Magazine. "Empathy: Do You Feel What I Feel?" An exploration of highly empathic practitioners and the experiences of sensing physical or emotional states in clients.